MRI-guided percutaneous thermoablation as first-line treatment of recurrent hepatic malignancies following hepatic resection: single center long-term experience.

PURPOSE: Hepatic recurrence of liver malignancies is a leading problem in patients after liver resection with curative intention. Thermoablation is a promising treatment approach for patients after hepatic resection, especially in liver-limited conditions. This study aimed to investigate safety, survival, and local tumor control rates of MRI-guided percutaneous thermoablation of recurrent hepatic malignancies following hepatic resection. MATERIAL AND METHODS: Data from patients with primary or secondary hepatic malignancies treated between 2004 and 2018 with MRI-guided percutaneous thermoablation of hepatic recurrence after prior hepatic resection were retrospectively analyzed. Disease-free survival and overall survival rates were calculated using the Kaplan-Meier method. RESULTS: A total of 57 patients with hepatic recurrence (mean tumor size = 18.9 ± 9.1 mm) of colorectal cancer liver metastases (n = 27), hepatocellular carcinoma (n = 17), intrahepatic recurrence of cholangiocellular carcinoma (n = 9), or other primary malignant tumor entities (n = 4) were treated once or several times with MR-guided percutaneous radiofrequency (n = 52) or microwave ablation (n = 5) (range: 1-4 times). Disease progression occurred due to local recurrence at the ablation site in nine patients (15.8%), non-local hepatic recurrence in 33 patients (57.9%), and distant malignancy in 18 patients (31.6%). The median overall survival for the total cohort was 40 months and 49 months for the colorectal cancer group, with a 5-year overall survival rate of 40.7 and 42.5%, respectively. The median disease-free survival was 10 months for both the total cohort and the colorectal cancer group with a 5-year disease-free survival rate of 15.1 and 14.8%, respectively. The mean follow-up time was 39.6 ± 35.7 months. CONCLUSION: MR-guided thermoablation is an effective and safe approach in the treatment of hepatic recurrences in liver-limited conditions and can achieve long-term survival.

Investigation of counterion influence on an octahedral IrH6-complex in the solid state hydrides AAeIrH6 (A = Na, K and Ae = Ca, Sr, Ba, and Eu) with a new structure type.

A number of new quaternary iridium based hydrides and deuterides AAeIrH/D(6) (where A = Na and K; Ae = Ca, Ba, Sr, and Eu) have been synthesized by direct combination of the alkali, alkaline earth or europium binary hydrides/deuterides and iridium powder. The crystal structures were determined by Guinier-Hägg X-ray and neutron powder diffraction and a new cubic structure type was found. The structure is described in space group F43m, but related to the K(2)PtCl(6) type structure. The new structure can be described as consisting of cubes of A(+) and Ae(2+) ions, where the A(+) and Ae(2+) ions alternates so that they occupy opposite corners in the cube. Every second cube contains a regular octahedral [Ir(III)H(6)](-3)-complex and the adjacent is empty. Solid-state IR spectroscopy was used to determine the Ir-allowed stretching and bending frequencies for the [Ir(III)H(6)](-3) complex with different counterions. These were also compared with the corresponding stretching frequencies for Fe(II)H(6), Ru(II)H(6), Os(II)H(6), and Ir(II)H(5) complexes in similar solid state hydrides, which increased when going from Fe through Ru, Os to Ir. The frequencies scaled almost linearly with the inverse of size of the cube surrounding the complexes but showed no significant dependence of the formal oxidation state or the experimentally obtained Ir-D distances. However, this was mainly because of difficulties in obtaining enough accurate atomic positions. The ab initio DFT calculations could reproduce the stretching frequencies within a few 10 cm(-1), indicating that experimental vibrational frequencies offer a sensitive test of DFT results.

Non-competitive cyclic peptides for targeting enzyme-substrate complexes.

Affinity reagents are of central importance for selectively identifying proteins and investigating their interactions. We report on the development and use of cyclic peptides, identified by mRNA display-based RaPID methodology, that are selective for, and tight binders of, the human hypoxia inducible factor prolyl hydroxylases (PHDs) - enzymes crucial in hypoxia sensing. Biophysical analyses reveal the cyclic peptides to bind in a distinct site, away from the enzyme active site pocket, enabling conservation of substrate binding and catalysis. A biotinylated cyclic peptide captures not only the PHDs, but also their primary substrate hypoxia inducible factor HIF1-α. Our work highlights the potential for tight, non-active site binding cyclic peptides to act as promising affinity reagents for studying protein-protein interactions.

Brodimoprim in maxillary sinusitis.

Recent studies on bacteriological findings in chronic maxillary sinusitis show a great variety of aerobic as well as anaerobic germs. For these reasons adequate chemotherapy has to support the necessary surgical procedure. In this study, the author reports about 60 adult patients suffering from chronic maxillary sinusitis. All of them had to undergo surgical treatment by the Caldwell-Luc procedure. Postoperatively, 30 of them were treated with brodimoprim, the others with doxycycline for 7 days. Bacteriological investigations have been performed during and at several days after surgery. At the same time, a number of laboratory data and the complications observed were registered. In this way, a comparative study of the two antibiotic drugs concerning the therapy of chronic maxillary sinusitis was established.

The diagnostic value of intranasal tests in allergic rhinopathy.

The method of the intranasal test, used by us, is described. It consists in a direct application of the allergen, which is presumed after a pilot-skin-test. The resulting reaction is documented by rhinomanometry. The special technical aspects of the test and the sources of error are emphasized.

[Occult sinusitis in childhood (author's transl)]. / Die okkulte Sinusitis im Kindesalter.

Occult sinusitis in childhood is a special form of chronic rhinosinusitis. The symptoms of chronic sinusitis are not clear in these patients, but the diagnosis can be confirmed both radiologically and endoscopically. Aetiologically, an immunoincompetence or mucoviscidosis should be remembered. As well as conservative measures, treatment by antral lavage or antrostomy is recommended.

[Laryngeal cancer and asbestosis]. / Kehlkopfkarzinom und Asbestose.

The article deals with the connection between an exposure to asbestos and the development of a laryngeal carcinoma. In accordance with case reports and epidemiological studies from literature, the above mentioned causality can be presumed in certain cases. Although at present there is usually no legal compensation for a laryngeal carcinoma if someone has been exposed to asbestos, the reports from literature as mentioned above should be taken into consideration in every single case: In detail, this means that anamnestical facts of exposure to asbestos, pulmological status and the latency up to the development of the laryngeal carcinoma must be taken into consideration.

[Biochemical aspects of human salivary gland secretions]. / Die Biochemie der menschlichen Speicheldrüsensekrete.

Salivary secretions fulfill some specific functions within the human organism, which are explained. The scientific research concerning these fluids dealt during the last years especially with the formation of these secretions within the glands. These investigations have been performed mostly in animal experiments. The results obtained are briefly summarized. For investigations in human salivary secretions, it was necessary to develop some new techniques for collecting the secretions from separate glands. The interpretation of sialo-chemical facts is often difficult as there are many factors, influencing the flow-rate and the composition of the fluids. These factors, as known up to now, are explained. In separate chapters, the inorganic and organic composition of human salivary secretions is described. Concerning the protein-composition of human saliva, there are some newer results as aspects, which are discussed. It must be the aim of a chemical analysis to discover the interrelation between the differences in salivary secretions and pathological conditions. Therefore changes of the salivary secretions in systemic diseases are reported as well as changes in the compositions of these fluids in pathological conditions of the glands themselves. According to the results from own experiments and from the literature, it should be possible in the future, to develop some new diagnostic methods by analysing the salivary secretions.

Tympanoplasty and tuberculosis of the middle ear.

This report concerns 6 cases of middle ear tuberculosis. Typical clinical signs for this infection nowadays consist in a pale-coloured mucosa, spontaneous facial paresis, pneumatization of the mastoid and in a changing performation of the tympanic membrane. These signs can occur single or in combination. Under a specific chemotherapeutic treatment even in tuberculous infection of the middle ear tympanoplasty can be performed without danger for the newly transplanted tympanic membrane. One should consider tuberculous infection especially in cases when for apparently inexplicable reasons necrosis of the transplant occurs postoperatively.

[Mycoses of the paranasal sinus system]. / Mykosen des Nasennebenhöhlensystems.

BACKGROUND: During the last few years, in increasing number of fungal infections in the paranasal sinus system has been observed. Aspergillus species as well as mucor and candida albicans are especially responsible for these mycoses. PATIENTS: Twenty-seven cases of a fungal infection of the paranasal sinuses were observed between 1986 and 1997. The majority of the patients showed a chronic noninvasive form with affection of the maxillary sinus. Other forms (fulminant invasive form, chronic invasive form, allergic fungal sinusitis) are described. Typical features for fungal infection do exist in MRI and CT. CONCLUSIONS: A flexible therapeutic strategy is required in which appropriate pharmacologic and surgical options are tailored to the respective clinical picture.

[Aspergillosis of the nasal sinuses]. / Die Aspergillose der Nasennebenhöhlen.

Aspergillosis of the paranasal sinuses is located mainly in the maxillary sinus, in a few cases in the sphenoid sinus. In typical cases the infection is unilateral. As a rule, the infection leads to a concrement formation in the diseased sinus. This concrement is sometimes characterised by dense masses of calcium phosphate, which seem like metallic structures on x-ray film. With regard to the course of aspergillosis in the paranasal sinuses, we must distinguish between an invasive-destructive form and a non-invasive form. The non-invasive form can be healed by removing the mycotic masses by surgical procedures. In the course of the invasive-destructive form, surgical procedures must be supported by systemic antimycotic treatment. Nevertheless, prognosis in these cases is poor. Finally, it is pointed out that aspergillus infections of the paranasal sinuses can occur even without clearly established immunological deficiencies.

[Allergic Aspergillus sinusitis]. / Die allergische Aspergillus-Sinusitis.

The leading symptom of the allergic aspergillus sinusitis is the accumulation of mucoid material, Charcot-Leyden crystals and scattered aspergillus hyphae can usually be found. The mucosa itself shows a typically allergic reaction with distinct eosinophilia and additional inflammatory infiltrates. The histological and serological appearance of the allergic aspergillus sinusitis resembles that of allergic bronchopulmonary aspergillosis. The relation between these syndrome, as well as the treatment of allergic aspergillus sinusitis, are discussed.

[The immunglobulin-content of human parotid saliva (author's transl)]. / Der Immunglobulingehalt des menschlichen Parotissekretes

By means of radial immundiffusion, the content of IgA, IgG, IgM and IgE in 22 healthy persons was measured. The parotid saliva has been collected under standardized stimulation-conditions in 10 minutes-fractions during a time of 30 minutes. While IgM and IgE could not be found with this method, IgA and IgG were present in a concentration easy to be measured. For the two immunglobulins, a different and characteristical change in their concentration was found during stimulation. This difference can be explained by the different origin of the substances.

[On the absorption of decongestive nose-drops-investigation with a radioactive labelled imidazoline-derivate (author's transl)]. / Zur Resorption abschwellender Nasentropfen

In animal experiments, the absorption of a nasal decongestive substance after application to the nasal mucosa was studied. After an exposition-time of 60 minutes, about 1% of the substance applied could be measured in the total blood volume. An incorporation of the substance into proteins of the nasal mucosa could not be found. By means of frozen-section-autoradiography, the way of the applied decongestive substance through the mucosa could be investigated. The reasons for the relative small absorption rate are discussed. The chemical structure and the vasoconstrictory effect probably are reliable for that.

[Tuberculosis of the middle ear and tympanoplasty (author's transl)]. / Mittelohrtuberkulose und Tympanoplastik

The clinical picture of tuberculous otitis media is described. Nowadays the desease usually appears as a infection of the mucous membrane. The problems concerning the diagnosis of this specific infection by histological or bacteriological methods are discussed. Special questions about the performance of a tympanoplasty in a tuberculous otitis media are considered.

[Otologic manifestation of Wegener granulomatosis]. / Die otologische Manifestation der Wegenerschen Granulomatose.

Ever since Wegener first described the granulomatosis named after him, involvement of the middle ear tracts as a consequence of inflammatory changes in the nose and the nasopharynx has been known. In recent years there have been a remarkable number of reports on a primary affection of the mucosa of the middle ear with Wegener's granulomatosis. The corresponding symptoms clearly precede the affection of the typical parts of predilection in the upper respiratory tract. A 37-year old woman patient is reported to have fallen ill with a primary left-sided serous otitis media. Only several months later the changes typical of Wegener's granulomatosis concerning the nasal mucosa, trachea and especially the kidneys set in. The differential diagnostic difficulties appear with respect to the classification of inflammatory granulomatosis of the mucosa of the middle ear. The now valid concept of chemotherapy regarding treatment with cyclophosphamide and corticosteroids. Premature therapy can achieve encouragingly long remission of a relatively high number of cases of this disease.

[Endoscopic surgery in bilateral vocal cord paralysis (author's transl)]. / Endoskopische Eingriffe zur Glottiserweiterung bei beiderseitiger Stimmbandlähmung.

The surgical treatments of bilateral vocal cord paralysis are briefly described, and the various endoscopic excisions of the arytenoid are presented. For this latter surgery careful preoperative assessment is necessary. Problems related to the optimal time for surgery and to the surgical technique itself are discussed.

[Neurogenic tumor of the larynx (author's transl)]. / Neurogener Kehlkopftumor.

The authors report a case of a 13-year old girl with a neurogenic tumor of the larynx. The tumor was localized in the submucosal region of the arytenoid and aryepiglottic area on the left side of the larynx. Histologically, it was classified as a neurinoma. As it was impossible to remove the tumor totally by endoscopic way, a lateral hypopharyngotomy had to be performed. Two years after this procedure, there are no functional defects or signs of recurrency.

[Clinical and etiologic aspects of rupture of the membrane of the round window]. / Klinische und ätiologische Aspekte zur Ruptur der Membran des runden Fensters.

For more than 15 years, rupture of the round window membrane has been discussed as a possible cause of sudden sensineural hearing loss. With regard to the pathophysiological basis for such a rupture, an abnormality in the width of the aquaeductus cochlearis as well as anatomical variations of the round window membrane itself are presumed as causative factors. The authors report on six cases concerning this incidence. The indication for tympanoscopy and the technique for the closure of the round window fistula are reported. In 5 of the 6 patients treated in this manner, surgery the resulted in a significant and lasting hearing gain.